Acute-on chronic liver failure

J Hepatol. 2012 Dec;57(6):1336-48. doi: 10.1016/j.jhep.2012.06.026. Epub 2012 Jun 28.


Acute-on-chronic liver failure (ACLF) is an increasingly recognised entity encompassing an acute deterioration of liver function in patients with cirrhosis, which is usually associated with a precipitating event and results in the failure of one or more organs and high short term mortality. Prospective data to define this is lacking but there is a large body of circumstantial evidence suggesting that this condition is a distinct clinical entity. From the pathophysiologic perspective, altered host response to injury and infection play important roles in its development. This review focuses upon the current understanding of this syndrome from the clinical, prognostic and pathophysiologic perspectives and indicates potential biomarkers and therapeutic targets for intervention.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Brain / physiopathology
  • End Stage Liver Disease / complications*
  • End Stage Liver Disease / immunology
  • End Stage Liver Disease / therapy
  • Hemodynamics
  • Humans
  • Kidney / physiopathology
  • Liver / physiopathology
  • Liver Transplantation
  • Prognosis
  • Systemic Inflammatory Response Syndrome / complications